Russell, Latrece

Russell, Latrece is an individual health care provider with primary practice located at 4734 S Prairie Ave , Chicago IL 60615-1206. She recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Technician, Other, which is considered as her primary health care specialty. Russell, Latrece can be contacted via phone (708) 252-1958.

Contact Information

Primary practice address
4734 S Prairie Ave Chicago IL 60615-1206
Phone: (708) 252-1958
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X

Profile Details

NPI number 1073936100
LBN Legal business name Russell, Latrece
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2014
Last updated Jan 24th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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